follow-up study of macrocephalic children with enlargement of the subarachnoid space estudo evolutivo de crianças macrocefálicas com alargamento do espaço sub-aracnóideo

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ID: 251716
1992
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Abstract
Eighteen macrocephalic children with enlargement of the subarachnoid space (ESAS), with or without mild ventricular dilatation, were followed prospectively to a mean age of 56 months. All were born at term, with uneventful neonatal period and negative tests for congenital infections. There were 17 boys and 1 girl and the mean follow-up period was 46 months (8-58 months). The initial neurologic evaluation, between ages of 2 to 33 months, disclosed abnormalities in 2 cases. At the follow-up one was still abnormal and the other had a normal neurological examination. Another child, who had a normal neurological examination at the age of 5 months, at the age of 7 years and 7 months had an IQ of 77. Thus the abnormality rate at follow-up was 11%. The OFC returned to the normal range in 45% of the children at the follow-up period. There were no cases of intracranial hypertension. One infant had subdural taps performed at the age of 13 months that disclosed a fluid with the same characteristics as the CSF. All the children had a CT-scan performed at the beginning of the study that revealed a large subarachnoid space; in 77% it was associated with mild ventricular dilatation. Eleven had CT-scans repeated, during the study period, which showed resolution of the process in 3 cases, improvement in 2, and unchanged in 6. We conclude that enlargement of the subarachnoid space in macrocephalic children is often a benign entity. ESAS and macrocephaly will still be present in the majority of children in the long-term follow-up.
Trata-se de estudo prospectivo de 18 crianças com macrocefalia por aumento do espaço sub-aracnóideo, com ou sem dilatação ventricular, seguidas até idade em média de 56 meses. Todas nasceram a termo, sem intercorrências perinatais e com testes negativos para TORCH. O tempo médio de seguimento foi 46 meses. Havia 17 meninos e apenas uma menina no grupo estudado. A porcentagem de anormalidades neurológicas no seguimento foi de 11%. Durante o seguimento, o perímetro cefálico retornou aos níveis da normalidade em 45% das crianças. Nenhum caso desenvolveu hipertensão intracraniana durante o estudo. Todas as crianças realizaram TAC de crânio como parte da avaliação inicial e, além do aumento do espaço sub-aracnóideo peri-encefálico, 77% delas apresentavam discreta dilatação ventricular. No seguimento, 11 realizaram TAC de controle que revelaram resolução completa do processo em 3 casos, melhora em 2 e permaneceram inalteradas em 6. Concluimos que o aumento do espaço sub-aracnóideo em crianças macrocefálicas é entidade que apresenta bom prognóstico neurológico na maioria dos casos e que a macrocefalia e o aumento do sub-aracnóideo continuarão presentes, na maioria das crianças, no seguimento a longo prazo.
Reference Key
gherpelli1992arquivosfollow-up Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;J. L. D. Gherpelli;V. Scaramuzzi;M. L. G. Manreza;A.J. Diament
Journal communications in computer and information science
Year 1992
DOI
DOI not found
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1992000200004
Keywords
macrocephaly neuropsychiatry biological psychiatry

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